Novel Aspects of 3D Echocardiography in Percutaneous Mitral Valve Interventions: Update 2013

The rapidly increasing importance of percutaneous treatment options for mitral valve diseases promotes the demand for reliable periprocedural guidance by transesophageal echocardiographic imaging. For several interventional mitral leaflet repair techniques real-time 3-dimensional transesophageal echocardiographic (RT3D TEE) guidance has been described to be indispensible. RT3DE TEE provides excellent insight into the mitral valve pathology, which improves procedure planning, safe guidance of device navigation and direct assessment of procedural success. For balloon mitral valvuloplasty 3D echocardiography has shown to effectively accelerate the procedure. The complexity of transcatheter mitral valve repair as well as transcatheter closure of paravalvular leakages of mitral valve prosthesis demands accurate evaluation of the target lesion and guidance of the navigation of the device catheter. All these features have recently found to be uniquely provided by three-dimensional echocardiography. The benefits of RT3D TEE led to its recommendation for percutaneous mitral valve repair procedures in current guidelines. This review of recent literature reports current applications and requirements for refinements in using 3D imaging modalities.